The Role of Higher Education in the Career Paths of Board-Certified Clinical Specialists in Geriatric Physical Therapy: Implications for Professional and Postprofessional Education

Abstract

Purposes. The purposes of this study were to examine the role of higher education in the career paths of board-certified specialists in geriatric physical therapy (GCSs) and to explore implications for professional and postprofessional education. Methods. Data included in-depth interviews in 1996 with the 1992 GCSs, open-ended questionnaire responses in 1999 from the 1995 GCSs, and American Physical Therapy Association survey data and document collection from both groups. Using a qualitative research method, common themes were sought among individuals. Results and Conclusions. Few participants had didactic exposure to geriatrics or gerontology in their professional education. None of 1992 GCSs and only two of the 1995 GCSs intended to work with older people following their professional education. Only later did the participants find themselves working primarily with older people and realized it was a good fit. The GCSs then sought specialization and both informal and formal postprofessional educational opportunities. The 12 GCS who participated in the initial in-depth interviews shared their insights on higher education as it related to professional and postprofessional education based on perceptions of their own lives and our health care system as it pertained to older people. All the participants believed in the value of lifelong learning for themselves and others. Their recommendations for professional and postprofessional education arose out of this core belief. INTRODUCTION In 1998, 12.7% of Americans were 65 years of age or older.1 Continued growth of the older population is anticipated, with the most rapid increases expected between 2010 and 2030 when the baby-boom generation reaches age 65 years. By 2030, older adults may represent 20% of the population if current immigration and fertility levels remain stable.1 In addition to their growing number, older people are the largest health care consumer group across delivery settings.1 Despite heavy medical usage as a group, most older adults do not fit the traditional medical model where a symptom is directly related to a disease that, once identified, is cured.2 Although many problems facing older people cannot be cured, health and independence are possible. Physical therapy addresses the needs of older people with the goal of progressing the individual toward optimal health. According to Kane and associates,3 small changes in function can make an enormous difference in the individual's quality of life. Therefore, physical therapists, especially board-certified clinical specialists in geriatric physical therapy (GCSs), may be in a position to positively affect the lives of elderly people and our aging society. However, there is some evidence that many physical therapists are not interested in working with older people. Noonan4 and Wong5 both expressed their concern with this negative attitude. Although little research6-9 has been published in this area, this apparent lack of interest, together with recent workforce reductions in settings dependent on Medicare reimbursement, may leave many older people without services that can make a significant difference in their quality of life. Unless more physical therapists choose to direct their careers toward a geriatric practice, the needs of older people may not be adequately met, given current demographic trends. The purposes of this study were to examine the role of higher education in the career paths of GCSs and to explore implications for professional and postprofessional education. To address these purposes, career and professionalization theories in education, sociology, and psychology were examined to identify an initial theoretical framework for this study. Most career theories focus on career selection and related individual traits. Professionalization theories tend to ignore individual professionalism and focus instead on the essential traits of professions. However, Young and Collin's approach to career theory addressed the entire career path, including individual professionalism. …